14 registered nurse case manager jobs found

Job Description Salary Range The expected base rate for this Glens Falls, New York, United States-based position is $40.83 to $60.74 per hour. (Exact rate is determined on a case-by-case basis commensurate with experience level, as well as education and certifications pertaining to each position which may be above the listed job requirements.) The Impact You Can Make The Case Manager (Acute Care) role must optimize and integrate the interface between clinical and financial systems supporting positive health outcomes. The Case Manager uses nursing and case management knowledge to promote appropriate allocation of hospital and other resources, while striving to provide high quality care to each patient in a cost effective and timely manner. Support services provided by the Case Manager include, but are not limited to, utilization review, case management, weekend and holiday case management, care transition, collaboration with physicians and social workers for care...

Location: Avera Health Plans Worker Type: Regular Work Shift: Day Shift (United States of America) Pay Range: The pay range for this position is listed below. Actual pay rate dependent upon experience. $31.00 - $46.25 Position Highlights You Belong at Avera Be part of a multidisciplinary team built with compassion and the goal of Moving Health Forward for you and our patients. Work where you matter. A Brief Overview Specialized nurse that identifies members who would benefit from complex/chronic condition case management and/or service coordination. The RN Case Manager develops and facilitates the member's plan of care. In collaboration with physicians, population health staff, employers, community organizations, hospital-based case managers/utilization review staff, clinic-based care coordinators/preauthorization staff, and Insurance Division staff, the RN Case Manager encourages the best possible outcome in the most cost effective manner in...

Location: Avera Health Plans Worker Type: Regular Work Shift: Day Shift (United States of America) Pay Range: The pay range for this position is listed below. Actual pay rate dependent upon experience. $31.00 - $46.25 Position Highlights You Belong at Avera Be part of a multidisciplinary team built with compassion and the goal of Moving Health Forward for you and our patients. Work where you matter. A Brief Overview Specialized nurse that identifies members who would benefit from complex/chronic condition case management and/or service coordination. The RN Case Manager develops and facilitates the member's plan of care. In collaboration with physicians, population health staff, employers, community organizations, hospital-based case managers/utilization review staff, clinic-based care coordinators/preauthorization staff, and Insurance Division staff, the RN Case Manager encourages the best possible outcome in the most cost...

Location: Avera McKennan Hospital Worker Type: Regular Work Shift: Day Shift (United States of America) Pay Range: The pay range for this position is listed below. Actual pay rate dependent upon experience. $34.50 - $51.50 Position Highlights You Belong at Avera Be part of a multidisciplinary team built with compassion and the goal of Moving Health Forward for you and our patients. Work where you matter. A Brief Overview Facilitates the plan for an orderly transition of patients from the Med/Surg and medical ICU acute area settings to the next appropriate level of care. Works closely with physicians and payors to assure proper use of fiscal resources. Serves as liaison with physicians and staff to assure on going continuity. What you will do Provides customer service and communicates in a courteous manner consistent with principles of service excellence in order to achieve patient, family and physician satisfaction....

Inspire health. Serve with compassion. Be the difference. Job Summary Integral care team partner that focuses on patient engagement and activation, has primary accountability for patients' care transition out of the acute care setting and positively impacts longitudinal care plan alignment. In collaboration with physicians, leads the multidisciplinary team including clinical staff and payors to ensure efficient delivery of quality, cost-effective care. Leads the team for each patient individually with the goal to maximize autonomy where possible. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference. Partners with the attending providers throughout hospitalization to promote effective and efficient utilization of clinical resources, ensuring quality, cost effective care. Anticipate next steps and facilitate communication to maximize care...

Location: Hollywood, Florida At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience. Summary: Assumes 24-hour accountability for managing the functions of Access, Care Coordination, and Discharge Planning. With the Manager - Social Work, serves as the central resource to the Director - Case Management to develop strategies which are efficient, effective, timely, patient-centered, and support appropriate financial reimbursement. To meet accountabilities of the Care Management Dashboard, collaborates with all disciplines, departments, payers, system partners, vendors, and community agencies to optimize clinical outcomes within best practice, ethical, legal, and regulatory parameters. Responsibilities: Assists with the preparation and evaluation of departmental...

Location: Hollywood, Florida At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience. Summary: Assumes 24-hour accountability for managing the functions of Access, Care Coordination, and Discharge Planning. With the Manager - Social Work, serves as the central resource to the Director - Case Management to develop strategies which are efficient, effective, timely, patient-centered, and support appropriate financial reimbursement. To meet accountabilities of the Care Management Dashboard, collaborates with all disciplines, departments, payers, system partners, vendors, and community agencies to optimize clinical outcomes within best practice, ethical, legal, and regulatory parameters. Responsibilities: Assists with the management and evaluation of department...

Overview Reporting to the Case Management Director, the Case Management Manager is responsible to assist in the development, planning, coordination, and administration of the Case Management department. Including, but not limited to being a resource and first level in the Case Management chain of command for support and escalation of issues for the Case Management staff. Qualifications Education: Bachelors of Science in Nursing preferred; Associates in Nursing required License: Alabama Registered Nurse License Experience: Three years experience in case management or utilization management preferred. Registered Nurse with at least one year clinical experience on a medical/surgical unit with excellent communication skills and ability to work collaboratively with all members of the health care team.

POSITION SUMMARY/RESPONSIBILITIES Provides strategic leadership for Utilization Management programs and initiatives. Responsible for accreditation readiness, regulatory compliance oversight, performance improvement planning, delegated oversight, operational governance, and implementation of organizational UM strategies. Serves as a liaison between operational leadership, Medical Directors, executive leadership, regulatory agencies, and accreditation organizations. Provides leadership, oversight, direction, and performance management for Utilization Management staff, including clinical reviewers, denial and appeals staff, and administrative personnel. Oversees utilization review operations, prior authorization activities, concurrent review, retrospective review, appeals support, and regulatory compliance activities. Ensures consistent application of medical necessity criteria, regulatory requirements, accreditation standards, and organizational policies. Leads quality...

Location: CHA Everett Hospital Work Days: 8-4:30pm including weekend rotation Category: Registered Nurse Department: Inpatient Case Management Everett Job Type: Per Diem Work Shift: Day Hours/Week: 0.00 Union: Yes Union Name: MNA Everett DEPARTMENT DESCRIPTION: Inpatient Case Management provides psychosocial assessments, evaluations, and referrals for adults, and/or families with psychiatric illness, substance abuse, and medical illness. Casework or therapy takes place in the hospital setting. Cross Training to all areas of Care Management Under the general supervision of the Director of Care Management, the RN Case Manager provides clinically-based case management to support the delivery of effective and efficient patient care consistent with the Centers for Medicaid and Medicare Conditions of Participation. The RN Case Manager will collaborate with other members of the health care team to identify appropriate utilization of resources...

Position Summary The Manager of Case Management & Social Services is responsible for the overall leadership, management, and daily operations of the Case Management and Social Services departments. This position provides strategic and operational oversight to ensure the delivery of high-quality, patient-centered care coordination, discharge planning, utilization management, and psychosocial services across the continuum of care. The Manager collaborates with physicians, nursing leadership, ancillary departments, post-acute providers, and community agencies to promote safe, timely, and efficient patient transitions while supporting regulatory compliance, quality outcomes, and financial stewardship.  The Manager oversees a multidisciplinary team of registered nurse case managers, licensed clinical social workers, social workers, case management assistants, and other support staff. Responsibilities include supervising departmental operations, developing...

Position Summary EMPLOYER-PAID PENSION PLAN ( NEVADA PERS)  COMPETITIVE SALARY & BENEFITS PACKAGE As an academic medical center with a rich history of providing life-saving treatment in Southern Nevada, UMC serves as the anchor hospital of the Las Vegas Medical District, offering Nevada’s highest level of care to promote successful medical outcomes for patients. UMC is home to Nevada's ONLY  Nonprofit Level I Trauma Center, Verified Burn Center, and Multi-Organ Transplant Center. In 2026, we became the FIRST and ONLY Magnet®-Recognized hospital in the state, reflecting UMC's nursing professionalism, teamwork, and superiority in patient care. THIS POSITION IS CONSIDERED AT-WILL AND WILL SERVE AT THE PLEASURE OF THE CEO. Sign-on Bonus up to 10K (depending on experience/location)   Position Summary: Develops, implements and maintains a system of outcome management. Ensures coordination of care across the continuum on a financial platform.  

When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives. Manages the Utilization Management (UM) team, maintaining effective and efficient processes for determining appropriate patient admission status based on regulatory and reimbursement requirements of various commercial and government payers. Manages UM department in the context of other Revenue Cycle functions such as Denials & Appeals, Patient Access, Authorization Management & review, HIM, Coding & Billing. Close collaboration with the Physician Advisors, Collaborates and helps facilitate the Utilization Review Committee. Continuously monitors processes for opportunities for improvement within an interdisciplinary team and integrated Revenue Cycle effort. Job Description: Essential Duties & Responsibilities including but not limited to: Ensures that Utilization Review nurses are consistently recommending the appropriate admission...

Overview About the Role: The primary purpose of the Case Management Coordinator position is to coordinate the patient’s progress through the system. He/she collaborates with physicians and clinical staff to ensure resource utilization is appropriate to the patient’s clinical and psychosocial needs and that it remains within covered benefits. The Case Management Coordinator seeks creative solutions to process and system issues, which create a barrier to the delivery of medically appropriate, cost-effective care. He/she is responsible to ensure compliance with regulatory standards related to level of care determinations, utilization and discharge planning. The Case Management Coordinator performs transitions of care and discharge planning, and supports the mission of University Hospital. Responsibilities What You’ll Do: Service provided is patient centered; actively contributes to creating a friendly, welcoming and...